KEF Registration Form 2019-2020
Members: $170/Session
Non-Members: $210/Session
Parent/Guardian 1
First Name
Last Name
Email
Mobile
Home Phone
Are you a member at Holy Blossom Temple?
Yes
No
How many children are you registering?
Please select...
1
2
3
Child 1
Child information
First Name
Last Name
Grade in September 2019
Please select...
Junior Kindergarten
Senior Kindergarten
Grade 1
Waiver
I hereby permit my child to participate in the Holy Blossom Temple KEF program during the 2019-2020 fiscal year under supervision. I hereby release Holy Blossom and their employees and agents from all manner of cause of actions for personal injury, damage to property or otherwise, arising out of my child’s participation in an event.
Agree
Program Choices
Register for 1, 2 or 3 sessions!
Session 1 (Sept 15 - Nov 17):
Jewnior Bakers
Session 2 (Nov 24 - Feb 9):
Creative Art
Session 3 (Feb 23 - May 3):
Superscience
Register for 1, 2 or 3 sessions!
Session 1 (Sept 15 - Nov 17):
Jewnior Bakers
Session 2 (Nov 24 - Feb 9):
Creative Art
Session 3 (Feb 23 - May 3):
Superscience
Child 2
Child information
First Name
Last Name
Grade in September 2019
Please select...
Junior Kindergarten
Senior Kindergarten
Grade 1
Waiver
I hereby permit my child to participate in the Holy Blossom Temple KEF program during the
2019-2020
fiscal year under supervision. I hereby release Holy Blossom and their employees and agents from all manner of cause of actions for personal injury, damage to property or otherwise, arising out of my child’s participation in an event.
Agree
Program Choices
Register for 1, 2 or 3 sessions!
Session 1 (Sept 15 - Nov 17):
Jewnior Bakers
Session 2 (Nov 24 - Feb 9):
Creative Art
Session 3 (Feb 23 - May 3):
Superscience
Register for 1, 2 or 3 sessions!
Session 1 (Sept 15 - Nov 17):
Jewnior Bakers
Session 2 (Nov 24 - Feb 9):
Creative Art
Session 3 (Feb 23 - May 3):
Superscience
Child 3
Child information
First Name
Last Name
Grade in September 2019
Please select...
Junior Kindergarten
Senior Kindergarten
Grade 1
Waiver
I hereby permit my child to participate in the Holy Blossom Temple KEF program during the
2019-2020
fiscal year under supervision. I hereby release Holy Blossom and their employees and agents from all manner of cause of actions for personal injury, damage to property or otherwise, arising out of my child’s participation in an event.
Agree
Program Choices
Register for 1, 2 or 3 sessions!
Session 1 (Sept 15 - Nov 17):
Jewnior Bakers
Session 2 (Nov 24 - Feb 9):
Creative Art
Session 3 (Feb 23 - May 3):
Superscience
Register for 1, 2 or 3 sessions!
Session 1 (Sept 15 - Nov 17):
Jewnior Bakers
Session 2 (Nov 24 - Feb 9):
Creative Art
Session 3 (Feb 23 - May 3):
Superscience
Fee & Payment
Total Program Fees
$
Payment Method
Please select...
Cheque
Credit Card
Preferred Payment Plan
Please select...
Pay in full
3 Payments (monthly)
Cheque
Please make all cheques payable to Holy Blossom Temple
Post-dated cheques are accepted
Payment must be paid in full by December 2019
Please send cheques to:
Holy Blossom Temple ATTN: Lisa
1950 Bathurst Street
Toronto, ON M5P 2K9
Payment Information
Payment Amount
First Name
Last Name
Billing Address
Billing City
Billing Province
Please select...
AB
BC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
YT
Billing Postal Code
*Please make sure the billing address matches the credit card given. Thank you.
Credit Card
Visa or Mastercard
Expiry Month
Please select...
1
2
3
4
5
6
7
8
9
10
11
12
Expiry Year
Please select...
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
Designation ID
Authnet_Hidden_Fields
reCAPTCHA helps prevent automated form spam.
The submit button will be disabled until you complete the CAPTCHA.
Contact Information
